In this section
Poisoning – Acute guidelines for initial managementResuscitation
24 hour advice, contact Victorian Poisons Information Centre 131126
Clinical features due to phenobarbitone ingestion are mainly due to central nervous system depression and effect on the cardiovascular system. Symptoms include lethargy, slurred speech, ataxia, hypotension and arrhythmias.
Onset of symptoms is usually within an hour of ingestion and symptoms may be profound and prolonged.
Serum phenobarbitone concentrations can be useful for confirming the ingestion but are not a reliable predictor of clinical course.
All children with deliberate self-poisoning or significant (>5mg/kg OR >10mg/kg greater than the child’s normal therapeutic dose if on regular dose) accidental ingestion
Any symptomatic child
Acute ingestion of unknown quantity
Any child where the developmental age is inconsistent with accidental poisoning as non-accidental poisoning should be considered.
Intentional overdose or accidental
Co-ingestants e.g. paracetamol
Always check for Medicalert bracelet in any unconscious patient, or any other signs of underlying medical condition (fingerprick marks etc.)
Consider the possibility of co ingestions, either accidental or deliberate
ECG: (initially and repeat at 6 hours until normal).
Paracetamol concentration in all intentional overdoses
If phenobarbitone serum concentrations performed:
(e.g. ataxia, blurred vision)
(e.g. Depressed conscious state or cardiac arrhythmias)
Admission should be considered for all children with an intentional overdose or in children with persisting symptoms after 6 hours observation.
Consult Contact Victorian Poisons Information Centre 131126 for advice
Children with severe symptoms and/or the potential to require intensive care review.
For emergency advice and paediatric or neonatal ICU transfers, call the Paediatric Infant Perinatal Emergency Retrieval (PIPER) Service: 1300 137 650.
Period of observation as above
For deliberate ingestion a risk assessment should indicate that the child is at low risk of further self-harm in the discharge setting
prevention for children Parent
Victorian Poisons Information Centre: 13 11 26 www.austin.org.au/poisons
Intentional self-harm: Referral to local mental health services e.g. Orygen Youth Health: 1800 888 320
Recreational poisoning: Referral to YoDAA, Victoria's Youth Drug and Alcohol Advice service: 1800 458 685
Last Updated December 2017